Provider First Line Business Practice Location Address:
10651 E STREET
Provider Second Line Business Practice Location Address:
NAVAL HOSPITAL CORPUS CHRISTI ATTN COMMANDING OFFICER
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78419-5131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-961-4311
Provider Business Practice Location Address Fax Number:
361-961-2529
Provider Enumeration Date:
11/30/2005